Objectives: The three objectives were: 1) to clarify the meaning of the concept of patient satisfaction 2) to review and modify an existing measure of patient satisfaction in light of the clarified meaning and 3) to test the reliability and validity of the revised measure. Design: The first phase of the design consisted of the conceptual clarification using procedures suggested by Walker and Avant (1988) and Wilson (1963) The second part of the design was the study of the psychometric properties of the revised instrument including reliability and validity testing in two hospital settings. Population, Sample, Setting, Years: The population was hospitalized patients. Two samples were drawn from 2 hospitals. The first sample was used to test the construct validity of the instrument and the second sample was used to confirm the model developed from the first sample. The settings were both large urban not-for-profit hospitals. The years were 1992-1993. Concept or Variables Studied Together of Intervention and Outcome Variable(s): Patient satisfaction with nursing care is viewed as an outcome variable. For this study the concept was patient satisfaction studied from a concept clarification point of view for the purpose of instrument refinement and testing. Methods: The concept clarification consisted of: 1) conducting a broad review of literature to discover all possible uses of the concept 2) listing the defining characteristics or critical attributes, (3) constructing types (model, borderline, contrary, related), (4) identifying antecedents and consequences, and (5) determining the empirical referents for the critical attributes. In addition, a marketing model was identified from the literature to form the framework for the instrument. The psychometric testing consisted of using the first sample of 230 willing respondents to explore the identification of a structural equation model using the software EQS. Internal consistency reliability was estimated using the ICC. The second sample of 103 was used to confirm the model identified from the first sample and verify the internal consistency reliability. In addition, to provide evidence of predictive validity supervisors from both settings identified units they thought would have the highest scores and those that would have the lowest scores. Findings: Patient satisfaction was defined as the result of patients' evaluation of the degree of congruence between their expectations of the nurse and the patient's perceptions of actual or experienced nurse behaviors/characteristics. Consequently several items of the original instrument were reworded and several new items were developed. Also items related to patient judgments of nurses knowledge and skill were deleted The measurement model developed from the first sample revealed two factors (Art of Care and Tangibles/Environment) with six items in each. A test of a higher order factor revealed a significant higher order factor (patient satisfaction) indicating a relationship between the two original factors. Three re-specifications of the model resulted in a CFI of .991 The ICC revealed a reliability of 0.93 and 0.91 for the two factors and 0.94 for the higher order factor with no interaction effects. The model identified in the first sample was confirmed with the second sample. The CFI for the second sample was .960. The ICC for the second sample was 0.93 for the two factors and 0.96 for the higher order factor again with no interaction effects. Significant differences were found between patient care units and in the directions predicted by the supervisors. Conclusions: There is evidence for construct validity for the revised instrument. There is also evidence for predictive validity. The intraclass correlation coefficients for the subscales and total scale are high and reveal no interaction effects. The revised instrument is a valid and reliable measure of patient satisfaction with nursing care in the hospital setting. Implications: This instrument can be used for evaluating patient satisfaction with nursing care in general hospital settings.

<table><tr><td colspan="2" class="item-title">Instrument Refinement Using Concept Clarification and Measurement Model Testing</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Eriksen, Lillian, DNS/DNSc/DSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Texas Health Science Center at Houston</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lillian.eriksen@uth.tmc.edu</td></tr><tr><td colspan="2" class="item-abstract">Objectives: The three objectives were: 1) to clarify the meaning of the concept of patient satisfaction 2) to review and modify an existing measure of patient satisfaction in light of the clarified meaning and 3) to test the reliability and validity of the revised measure. Design: The first phase of the design consisted of the conceptual clarification using procedures suggested by Walker and Avant (1988) and Wilson (1963) The second part of the design was the study of the psychometric properties of the revised instrument including reliability and validity testing in two hospital settings. Population, Sample, Setting, Years: The population was hospitalized patients. Two samples were drawn from 2 hospitals. The first sample was used to test the construct validity of the instrument and the second sample was used to confirm the model developed from the first sample. The settings were both large urban not-for-profit hospitals. The years were 1992-1993. Concept or Variables Studied Together of Intervention and Outcome Variable(s): Patient satisfaction with nursing care is viewed as an outcome variable. For this study the concept was patient satisfaction studied from a concept clarification point of view for the purpose of instrument refinement and testing. Methods: The concept clarification consisted of: 1) conducting a broad review of literature to discover all possible uses of the concept 2) listing the defining characteristics or critical attributes, (3) constructing types (model, borderline, contrary, related), (4) identifying antecedents and consequences, and (5) determining the empirical referents for the critical attributes. In addition, a marketing model was identified from the literature to form the framework for the instrument. The psychometric testing consisted of using the first sample of 230 willing respondents to explore the identification of a structural equation model using the software EQS. Internal consistency reliability was estimated using the ICC. The second sample of 103 was used to confirm the model identified from the first sample and verify the internal consistency reliability. In addition, to provide evidence of predictive validity supervisors from both settings identified units they thought would have the highest scores and those that would have the lowest scores. Findings: Patient satisfaction was defined as the result of patients' evaluation of the degree of congruence between their expectations of the nurse and the patient's perceptions of actual or experienced nurse behaviors/characteristics. Consequently several items of the original instrument were reworded and several new items were developed. Also items related to patient judgments of nurses knowledge and skill were deleted The measurement model developed from the first sample revealed two factors (Art of Care and Tangibles/Environment) with six items in each. A test of a higher order factor revealed a significant higher order factor (patient satisfaction) indicating a relationship between the two original factors. Three re-specifications of the model resulted in a CFI of .991 The ICC revealed a reliability of 0.93 and 0.91 for the two factors and 0.94 for the higher order factor with no interaction effects. The model identified in the first sample was confirmed with the second sample. The CFI for the second sample was .960. The ICC for the second sample was 0.93 for the two factors and 0.96 for the higher order factor again with no interaction effects. Significant differences were found between patient care units and in the directions predicted by the supervisors. Conclusions: There is evidence for construct validity for the revised instrument. There is also evidence for predictive validity. The intraclass correlation coefficients for the subscales and total scale are high and reveal no interaction effects. The revised instrument is a valid and reliable measure of patient satisfaction with nursing care in the hospital setting. Implications: This instrument can be used for evaluating patient satisfaction with nursing care in general hospital settings.<br/><br/></td></tr></table>

en_GB

dc.date.available

2011-10-26T11:13:56Z

-

dc.date.issued

2002-07

en_GB

dc.date.accessioned

2011-10-26T11:13:56Z

-

dc.description.sponsorship

Sigma Theta Tau International

en_GB

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